| NPI | 1508805052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0009X Ophthalmology, Glaucoma Specialist (Licence: GA 047336) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 047336) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2019-01-10 |